Disposable anesthesia delivery system with shortened outer sleeve and inner hollow drill

ABSTRACT

An intraosseous delivery apparatus having a drilling member and a sleeve member. The drilling member includes a drill housing, a connecting portion for establishing a connection to a conventional dental drilling apparatus, and a drill extending from the drill housing. The sleeve member includes a sleeve housing, and a hollow sleeve extending from the sleeve housing. The sleeve housing is adapted to be removably engaged with the drill housing such that the drill is inserted into the hollow sleeve. The drill has a length such that when the drill is inserted into the hollow sleeve, a portion of the drill extends beyond the hollow sleeve. As a result, when the drill is used to drill a hole in bone, the drill is inserted deeper into the hole than the hollow sleeve. The hollow sleeve is adapted to be left inserted in the bone when the drill is removed therefrom. The “in place” hollow sleeve is also adapted to receive a syringe needle through which anesthesia may be directly introduced into the bone via an exposed bottom portion of the drilled hole as well as via exposed side-wall portions of the drilled hole. The drill is preferably smooth, and may also be hollow so that debris generated during drilling enters the interior of the drill. In this case, when the hollow drill is removed from the hollow sleeve, the debris within the hollow drill may also be removed.

BACKGROUND OF THE INVENTION

The present invention relates to an improved disposable delivery systemfor intraosseously delivering anesthesia to the jawbone or other partsof the living body. In particular, the present invention relates to animprovement of the disposable intraosseous anesthesia delivery apparatusand method disclosed in earlier U.S. application Ser. No. 09/165,010 andearlier PCT Application U.S. Ser. No. 99/07728, the entire contents ofboth of which are incorporated herein by reference.

The present invention is described in detail below with respect toapplication of dental anesthesia, but the invention is applicable todelivery of anesthesia or other fluids to other parts of a living body,either human or animal. In particular, the present invention isapplicable to other surgical procedures such as, for example, orthopedicsurgical procedures. Thus, although the invention is described in detailwith respect to delivery of dental anesthesia, the invention is notintended to be limited to use only in connection with dental procedures.

In general, anesthesia is delivered by injection of a topical anestheticfollowed by a deeper injection of anesthetic for desensitizing nerveendings within the region of interest (infiltration) or for blocking offremote sensory nerves which are coupled to the region of interest (nerveblocking).

It is desirable to minimize the amount of anesthesia injected becausetoxic reactions may result from drug sensitivity or misdirection of theinjection needle into the bloodstream. Such risk of toxic reaction isheightened when repeated administration of anesthesia as required, as isoften the case with conventional delivery techniques. In addition,conventional administration of dental anesthesia generally results innumbness of the tongue, cheek, lips and/or even part of the face of thepatient for some time after a procedure.

As set forth in U.S. Pat. No. 4,944,677 to Alexandre, conventionalmethods of delivering dental anesthesia include injection into mucoustissue, injection into a ligament, injection into the septum andinjection near a nerve-trunk. However, injection into mucous tissue isdisadvantageous because it takes a long time for the anesthesia to takeeffect (about 5 minutes), because the amount of anesthesia is high(about 4 cc), and because adrenalin or another vaso conductor isrequired for cardiac patients. Injection into a ligament isdisadvantageous because it requires high pressure for injection (whichcauses pain), because injection is into a septic area, because the riskof infection of the ligament is increased, and because the risk ofpost-operative problems including inflammation and necrosis isincreased. Injection into the septum is disadvantageous because it alsorequires high pressure for injection (which causes pain), because exactpositioning of the needle is required, and because injection is into aseptic area. And finally, injection near the nerve-trunk isdisadvantageous because there is a long delay in effecting anesthesia(about 10 minutes), because there is a high risk of inadvertentinjection into a blood vessel, and because post-operative numbness isvery long lasting.

Intraosseous delivery of dental anesthesia directly into the jawbone isalso known. Intraosseous delivery is extremely advantageous because itvery rapidly achieves numbness limited only to the tooth to be treated,because it enables the amount of anesthetic to be significantly reduced,and because post-operative numbness is essentially avoided. The mostrelevant prior art intraosseous delivery techniques are describedhereinbelow.

U.S. Pat. No. 2,317,648 to Siqveland discloses an intraosseous deliveryapparatus and method whereby a threaded sleeve is concentrically andremovably positioned around a drill. The drill and threaded sleeve areused together to penetrate the bone, and then the drill is detached andwithdrawn, leaving the threaded sleeve embedded in the bone as a guidefor a hypodermic needle through which anesthesia may be injected. Afterinjection of anesthesia, the threaded sleeve is withdrawn from the boneby reverse rotation. The threaded sleeve disclosed in Siqveland,however, is too expensive to manufacture to be disposable and must beinserted at a slow speed due to the threading. In addition, the drilldisclosed in Siqveland is solid, so that debris which is generated bythe drill is left in the drilled hole, thereby reducing absorption ofthe anesthesia into the jawbone.

U.S. Pat. No. 4,944,677 to Alexandre discloses an intraosseous deliveryapparatus and method whereby a smooth, hollow drilling needle is used todrill a hole into the jawbone near the apex of a tooth to beanesthetized. The drilling needle is then removed from the jawbone and ahypodermic needle of substantially the same gauge as the drilling needleis then inserted into the hole formed in the jawbone using a single dropof blood formed during drilling as a marker for entrance to the hole.After the hypodermic needle is inserted into the hole, anesthesia isthen delivered by injection directly into the jawbone. This technique,however, is disadvantageous because in actual practice it is verydifficult to find the drilled hole and insert the hypodermic needletherein.

U.S. Pat. No. 5,432,824 to Akerfeldt et al discloses a method ofaccessing a hard tissue whereby a needle drill is inserted into andthrough a cannula and then used to drill a hole in hard tissue. Thedistal end of the needle drill has eccentrically shaped tip, so that thedrilled hole has a larger diameter than the needle drill and thecannula. After the hole is drilled, the cannula is inserted into theoversized hole. The needle drill is then removed, and the cannula isleft secured in the bone to act as a guiding channel for sampling oradministration of drugs. The needle drill of Akerfeldt et al, however,has a solid drilling tip, so that as in the case of Siqveland, debriswhich is generated by the drilling tip of the needle drill is left inthe drilled hole. Thus, if the method of Akerfeldt et al were used forthe injection of anesthesia, the absorption of the anesthesia would bereduced. In addition, drilling of an enlarged hole as taught byAkerfeldt results in more bone removal, a higher degree of heatgeneration during drilling, more trauma to the patient, a longer healingtime, and a higher risk of infection. Still further, because the holedrilled by Akerfeldt is oversized, the cannula is only loosely fitted inthe drilled hole, and injected anesthesia may leak backwards out of thehard tissue.

U.S. Pat. No. 5,762,639 to Gibbs discloses an apparatus and method forintraosseously delivering anesthesia whereby a solid rod is insertedinto a perforating catheter, and the assembled rod and perforatingcatheter are used to perforate ligament or bone tissue. After drilling,the rod is removed and the perforating catheter is left in place to beused as a guide for insertion of a hypodermic needle. In Gibbs, thedrilling needle is the outside member (i.e., the perforating catheter),and the rod which is inserted into the perforating catheter is used toprevent debris resulting from drilling from blocking the passage in theperforating catheter. The advantage of this technique is that theperforating catheter remains clear for injection of anesthesia, but thedisadvantage is that, as in Siqveland and Akerfeldt et al, the debriswhich is generated by the drilling is left in the drilled hole, therebyreducing absorption of the anesthesia into the jawbone. And because thedrilling needle of Gibbs is the outside member and bottoms in thedrilled hole, the bottom portion of the drilled hole is large. As inAkerfeldt et al, this results in more bone removal, a higher degree ofheat generation during drilling, more trauma to the patient, a longerhealing time, and a higher risk of infection.

SUMMARY OF THE INVENTION

It is an object of the present invention to provide an improveddisposable delivery apparatus and method for intraosseously deliveringanesthesia in a simple, easy and effective manner. In particular, it isan object of the present invention to provide an improved disposabledelivery apparatus and method capable of directly introducing anesthesiainto a hole drilled in a bone via an increased exposed bone surface areawhich is free of drilling debris, while significantly reducing thediameter of the distal end of the drilled hole. Increasing the exposedbone surface area enables greater absorption of the anesthesia, andreducing the diameter of the distal end of the drilled hole results inless bone removal, less heat generation during drilling, less patienttrauma, a shorter healing time, and a reduced risk of infection.

In order to achieve the above objects, the intraosseous deliveryapparatus of the present invention comprises a drilling member and asleeve member. The drilling member includes a drill housing, aconnecting portion for establishing a connection to a conventionaldental drilling apparatus, and a drill extending from the drill housing.The sleeve member includes a sleeve housing, and a hollow sleeveextending from the sleeve housing. The sleeve housing is adapted to beremovably engaged with the drill housing such that the drill is insertedinto the hollow sleeve. The drill has a length such that when the drillis inserted into the hollow sleeve, a portion of the drill extendsbeyond the hollow sleeve. As a result, when the drill is used to drill ahole in bone, the drill is inserted deeper into the hole than the hollowsleeve. The hollow sleeve is adapted to be left inserted in the bonewhen the drill is removed therefrom. The “in place” hollow sleeve isalso adapted to receive a syringe needle through which anesthesia may bedirectly introduced into the bone via an exposed bottom portion of thedrilled hole as well as via exposed side-wall portions of the drilledhole. The drill is preferably smooth, and may also be hollow so thatdebris generated during drilling enters the interior of the drill. Inthis case, when the hollow drill is removed from the hollow sleeve, thedebris within the hollow drill may also be removed.

BRIEF DESCRIPTION OF THE DRAWINGS

FIG. 1 is a partial sectional view of a drilling member and a sleevemember according to the present invention in an assembled state.

FIG. 2 is a perspective view of the assembled drilling member and sleevemember, and a disposal casing into which the drilling member and sleevemember may be removably inserted.

FIG. 3 is a perspective view showing the drilling member coupled to aconventional dental drilling apparatus, and a protective member beingremoved from the sleeve member.

FIG. 4 is a perspective view of the drilling member being removed fromthe sleeve member.

FIG. 5 is a partial sectional view of an alternative embodiment which isidentical to the embodiment shown in FIG. 1, except that the drill issolid.

FIG. 6 is a partial sectional view of an alternative embodiment whereinthe drilling member and the sleeve member are adapted to be coupled in a“male/female” configuration opposite to that shown in FIGS. 1-5.

FIG. 7 is a partial sectional view of the drilling member and the sleevemember of FIG. 6 in a connected state.

FIG. 8 is a partial sectional view showing an alternative alignment ofthe leading edges of the drill and the hollow sleeve when the drill isinserted into the sleeve.

FIG. 9 is an enlarged side view of a portion of a sleeve according to analternative embodiment wherein the sleeve has a serrated leading edge.

FIG. 10 is a partial sectional view showing another alternativeembodiment of the sleeve (with the drill inserted therein) wherein thesleeve has a substantially horizontal leading edge having a roughsurface.

FIG. 11 is an enlarged sectional view taken along line 11—11 shown inFIG. 10 (without showing the drill).

FIG. 12 is a partial sectional view showing another alternativeembodiment of the sleeve (with the drill inserted therein) wherein thesleeve has a tapered leading edge having a rough or smooth surface.

FIG. 13 is a side view of a portion of a sleeve according to anotheralternative embodiment wherein the sleeve has grooves formed on an outersurface thereof.

FIG. 14 is a sectional view taken along line 14—14 shown in FIG. 13.

FIG. 15 is an enlarged side view of a drill having a compound obliquecutting edge surface.

DETAILED DESCRIPTION

As shown in FIG. 1, the disposable anesthesia delivery apparatus of thepresent invention comprises a drilling member 1 and a sleeve member 2.The drilling member 1 comprises a drill housing 3, a shaft 4 extendingfrom the drill housing 3, a drill 5 embedded in the shaft 4 andextending through the drill housing 3, and a connecting portion 6 forconnecting the drilling member 1 to a conventional dental drillingapparatus. The sleeve member 2 comprises a sleeve housing 7 having aflared opening 9, and a hollow sleeve 8 extending from the sleevehousing 7.

As shown in FIG. 1, the drilling member 1 and the sleeve member 2 may becoupled together such that the drill 5 is inserted into the hollowsleeve 8. The drill 5 has a length such that a portion of the drill 5extends beyond the hollow sleeve 8 by a length l₁. The length l₁ may,for example, range from as small as 0.2 mm to about 7 mm. The length l₁is more preferably between about 2 mm and about 4 mm, and is mostpreferably about 3 mm. The hollow sleeve 8 preferably extends from thesleeve housing 7 by a length l₂ of between about 3 mm and about 9 mm,and the drill 5 preferably extends from the sleeve housing 7 by a lengthl₃ of between about 9 mm and about 10 mm.

The drill 5 may be hollow as shown in FIG. 1, or solid as shown in FIG.5, and the drill 5 may also be flexible or rigid. More specifically, thedrill 5 may, for example, be a standard stainless steel 27 gauge regularwall needle having an oblique cutting edge 10. Typically, a 27 gaugeregular wall needle has an outer diameter of about 0.4 mm, and an innerdiameter of about 0.25 mm. Alternatively, as shown in FIG. 5, the drill105 may be a solid member made of a metal such as surgical stainlesssteel having substantially the same outer diameter as the hollow drill 5of about 0.4 mm. Other dimensions for each of the hollow drill 5 andsolid drill 105 could also be used.

The drill 5/105 preferably has a smooth outer surface so as to enable ahigh rotational drilling speed to be utilized and so as to reduce damageto the gums or other tissues during drilling. The drill housing 3, shaft4 and connecting portion 6, moreover, may be formed of a surgical gradehigh impact poly-styrene with 20% calcium carbon or anothersubstantially rigid plastic, with the drill 5/105 being insert molded inthe shaft 4.

The sleeve 8 may, for example, be a standard syringe-type stainlesssteel needle having a 23 gauge thin wall. Typically, a 23 gauge regularwall needle has an outer diameter of about 0.62 mm, and an innerdiameter of about 0.42 mm. The sleeve 8, like the drill 5/105 preferablyhas a smooth outer surface, and the sleeve housing 7, like the drillhousing 3, may be formed of a surgical grade high impact polystyrenewith 20% calcium carbon or another substantially rigid plastic, with thesleeve 8 being insert molded in the sleeve housing 7.

As shown in FIG. 1, the drill housing 3 comprises an opening 16 intowhich a projecting portion 17 of the sleeve housing 7 may be removablyinserted. This coupling may, however, be reversed. That is, as shown inFIGS. 6 and 7, the drill housing 103 may comprise a projecting portion116 which may be removably inserted into an opening 117 of the sleevehousing 107.

As disclosed in detail in earlier U.S. application Ser. No. 09/165,010and earlier PCT Application U.S. Pat. No. 99/07728, the drilling member1 and the sleeve member 2 are preferably coupled together in anon-rotational manner. For example, as shown in FIG. 4, the sleevemember 2 may include an essentially square-shaped projection 14 whichmay be frictionally fitted within an essentially square cross sectionalopen portion 15 of the drilling member 1. As a result, a rotationaldriving force may be applied from the conventional dental drillingapparatus via the drilling member 1 to the sleeve member 2. Of course,other mating shapes can be used to achieve the non-rotational couplingand to enable the rotational driving force to be applied from theconventional dental drilling apparatus via the drilling member 1 to thesleeve member 2.

As shown in FIG. 2, the drilling member 1 and the sleeve member 2 arepreferably pre-assembled together and removably stored in a storage anddisposal casing 11. A protective member 12 may be removably formed onthe sleeve housing 7 via break away points 13. The protective member 12serves to protect a user from being inadvertently stabbed by the drill 5and the sleeve 8.

After usage, the drilling member 1 and sleeve member 2 may be reinsertedinto the casing 11 for safe disposal.

As shown in FIG. 3, the assembled drilling member 1 and sleeve member 2may be removably coupled to a conventional dental drilling apparatus,and the protective member 12 broken away at break away points 13 toexpose the sleeve 8 and the drill 5 extending therethrough. Theconventional dental drilling apparatus may then be operated to apply arotational driving force for driving the drill 5 to drill a hole in thejawbone of a patient. In addition, a pressing force may also be appliedto assist the drilling operation.

The pressing force and rotational driving force are applied until theflange 21 of the sleeve member 2 presses against or contacts the gums ofthe patient, thereby ensuring that the drill 5 has been fully insertedin the drilled hole. The surface of the flange 21 is preferably smoothand has rounded edges so as to not to damage the gums or other tissue ofthe patient during the drilling operation. In addition, the face of theflange 21 is preferably convex, so that the sleeve member 2 can berockingly leveraged when the sleeve member 2 is later removed from thebone.

As shown in FIGS. 1 and 5, respectively, the drill 5 and drill 105 aredimensioned to substantially fill the hollow sleeve 8. Thus, duringdrilling, the drill 5/105 serves to prevent cuttings and other debrisgenerated by the drilling from entering between the exterior of thedrill 5/105 and the interior of the hollow sleeve 8. As a result, whenthe drill 5/105 is removed from the hollow sleeve 8, a clear conduitinto the interior of the bone of the patient may be established via thehollow sleeve 8.

In addition, if, as shown in FIG. 1, the drill 5 is hollow, as the drill5 drills the hole in the bone of the patient, at least some of thedebris generated by the drilling will enter the interior of the drill 5.As a result, when the drill 5 is removed from the sleeve 8, the debriswithin the hollow drill 5 may also be removed. This will help tomaintain the drilled hole free of debris, so that the anesthesia orother fluid to be injected will be more easily and directly absorbedinto the bone.

The conventional dental drilling apparatus is preferably operated torotate the drill 5/105 at about 20,000 rpm during the drillingprocedure. However, speeds of about 10,000 to 25,000 rpm can be usedwith varying degrees of efficiency. As mentioned hereinabove, such highrotational speeds can be utilized because the drill 5/105 preferably hasa smooth outer surface. With the drill 5/105 rotating at such highspeeds, the hole in the bone can be quickly and painlessly drilled.Other speeds, for example below 10,000 rpm or above 25,000 rpm can alsobe used depending upon the specific application.

As the drill 5/105 drills the hole in the bone of the patient, a distalend of the sleeve 8 is caused to ream the drilled hole. This can beachieved in several ways. Namely, since the drilling member 1 and thesleeve member 2 are preferably non-rotationally coupled together, therotational driving force applied by the dental drilling apparatus to thedrilling member 1 will be conveyed to the sleeve member 2 torotationally drive the distal end of the sleeve 8 to ream the drilledhole. Alternatively and/or additionally, the manual pressing forceapplied to the drill will cause the distal end of the sleeve 8 to reamthe drilled hole. In either or both cases, the reaming action ensuresthat the distal end of the sleeve 8 will be securely and tightly fittedinto the drilled hole.

Once the drilling operation is completed, the drilling member 1 isdisengaged from the sleeve member 2 and the drill 5/105 is withdrawnfrom the sleeve 8. (See, for example, FIG. 4.) This is achieved, forexample, by exerting a rearward withdrawal force on the drilling member1 in the direction of arrow A while the sleeve member 2 is held inplace. The sleeve member 2 may be held in place by pressing aspecialized dental instrument or the U-shaped end 19 of the protectivemember 12 against the flange 21.

Significantly, because the drill 5/105 has a length such that the drill5 extends beyond the distal end of the sleeve 8 during drilling, thedrill 5/105 is inserted deeper into the drilled hole than the distal endof the sleeve 8. As a result, when the drilling member 1 is disengagedfrom the sleeve member 2 and the drill 5/105 is withdrawn from thesleeve 8, the distal end of the sleeve 8 will only be partly insertedinto the drilled hole. That is, the hole will have been drilled deeperthan the extent of insertion of the sleeve 8 in the hole. This willleave an increased exposed bone surface area, including the exposedbottom portion of the drilled hole and exposed side-wall portions at thedistal end portion of the drilled hole which extends beyond the sleeve8. As a result, the anesthesia or other fluid to be injected will have alarger surface area through which to be absorbed into the bone.

In addition, because the outer diameter of the drill 5/105 is notgreater than the outer diameter of the sleeve 8, the distal end portionof the drilled hole which extends beyond the sleeve 8 will also have asmaller diameter than the outer diameter of the sleeve 8. As a result,the diameter at the distal end of the drilled hole at the inner portionof the bone is reduced, thereby resulting in less bone removal, lessheat generation during drilling, less patient trauma, a shorter healingtime, and a reduced risk of infection.

After the drilling member 1 is disengaged from the sleeve member 2 andthe drill 5/105 is withdrawn from the sleeve 8, a conventional syringemay then be used to inject an anesthetic or other fluid into theinterior of the bone via the hollow sleeve 8. More specifically, asyringe needle is inserted through the flared opening 9 of the sleevemember 2 and into the hollow sleeve 8. The syringe needle must, ofcourse, have a gauge which is smaller than the inner diameter of thehollow sleeve 8 so that the syringe needle may be inserted into thehollow sleeve 8. Preferably, a sufficient clearance is provided betweenthe hollow sleeve 8 and the syringe needle such that a build up ofpressure is avoided when injecting the anesthetic or other fluid and sothat the syringe needle may be easily removed from the hollow sleeve 8.However, the syringe needle should be fitted sufficiently tightly withinthe hollow sleeve 8 so as to avoid back leakage of injected anestheticor other fluid therebetween. For example, the syringe needle may, likethe drill 5/105, be a standard stainless steel 27 gauge regular wallneedle having substantially the same outer diameter as the drill 5/105.

Preferably, the sleeve member 2 projects no more than about 5 mm fromthe gum surface when the device is used in dental applications. Thus,the sleeve member 2 is sufficiently small and unobtrusive so as not tointerfere with the dental procedure which is being performed. In mostcases, the sleeve member 2 may be left inserted in the jawbone of thepatient throughout the dental procedure. Accordingly, additionalanesthetic or other fluid may be applied, if and when necessary, via thehollow sleeve 8 which is left inserted in the bone of the patient.

At the end of the procedure, the sleeve 8 may be removed from the boneof the patient either by manually pulling the housing 7 of the sleevemember 2 or by using a pliers-type or U-shaped tool adapted to grip aportion of the sleeve member 2.

As shown in FIGS. 1-7, the cutting edge 10 of the drill 5/105 and theleading edge 18 of the sleeve 8 are oblique and aligned with each other.However, as shown in FIG. 8, the oblique cutting edge 10 and the obliqueleading edge 18 may be aligned opposite to each other. The obliquecutting edge 10 and the oblique leading edge 18 are preferably ground45-20 degrees relative to the longitudinal axes of the drill 5/105 andthe sleeve 8, respectively. Other alignments, angles, and/or drillingand reaming edge configurations are also possible.

As shown in FIG. 9, for example, the sleeve 8 may be provided with asubstantially horizontal serrated leading edge 118, or as shown in FIG.10, the sleeve 8 may be provided with a substantially horizontal leadingedge 218 having a rough surface. The rough surface of the leading edge218 is shown in FIG. 11 (enlarged and without showing the drill 5/105).The rough surface may be formed, for example, by sandblasting or byimpact with a sharp or pointed object. In addition, as shown in FIG. 12,the sleeve 8 may be provided with a tapered leading edge 318 having arough or smooth surface. The advantage of the tapering is that debrisgenerated during drilling may be deflected backward away from thedrilled hole.

As described hereinabove, the sleeve 8 preferably has a smooth outersurface. However, as shown in FIGS. 13 and 14, the sleeve 8 may havegrooves 20 formed on the outer surface thereof. The grooves 20 may beprovided to assist removal of the debris generated during drilling outof and away from the drilled hole.

Still further, as shown in FIG. 15, the drill 5/105 may have a cuttingedge 110 having a compound oblique surface made up of surface portions111 and 112 which have different angles relative to the longitudinalaxis of the drill 5/105.

Other combinations of the above described oblique, compound oblique,substantially horizontal, rough, smooth and/or tapered leading andcutting edges are also possible.

According to the present invention as described hereinabove, a direct,reusable communication path is established and maintained into the boneof the patient which enables simple injection and/or re-injection ofanesthetic or other fluid directly into the bone via an increasedexposed bone surface area which is free of drilling debris. Theanesthetic or other fluid can therefore be more efficiently absorbeddirectly into the bone, so that the dosage can be reduced while at thesame time producing a more rapid and shorter term effect. According tothe present invention, moreover, even though the absorption area isincreased, the diameter of the distal end of the drilled hole isreduced, thereby resulting in less bone removal, less heat generationduring drilling, less patient trauma, a shorter healing time, and areduced risk of infection.

Additional advantages and modifications will readily occur to thoseskilled in the art. Therefore, the invention in its broader aspects isnot limited to the specific details, representative devices, andillustrated uses and examples shown and described herein. Accordingly,various features of the respectively disclosed embodiments can be usedwith other embodiments, and various modifications and combinations maybe made without departing from the spirit or scope of the generalinventive concept of the present invention as defined by the appendedclaims and their equivalents. In particular, it is pointed out that inall the embodiments shown in the drawings, the drill may be solid orhollow.

What is claimed is:
 1. An intraosseous delivery apparatus comprising: adrilling member including a drill housing, a connecting portion forestablishing a connection to a dental drilling apparatus, and a hollowdrill extending from the drill housing; and a sleeve member including asleeve housing, and a hollow sleeve extending from the sleeve housing;wherein the sleeve housing is adapted to be removably engaged with thedrill housing such that the hollow drill is inserted into the hollowsleeve; wherein the hollow drill has a length such that when the hollowdrill is inserted into the hollow sleeve, a portion of the hollow drillextends beyond the hollow sleeve; wherein the hollow drill has a smoothouter surface, and the hollow sleeve has grooves formed along an outersurface thereof in a longitudinal direction; and wherein the hollowsleeve is adapted to receive a syringe needle when the sleeve housingand the drill housing are disengaged and the hollow drill is removedfrom the hollow sleeve.
 2. An intraosseous delivery method comprisingthe steps of: removably coupling a drilling member and a sleeve membersuch that a drill housing of the drilling member and a sleeve housing ofthe sleeve member are removably engaged, and such that a hollow drillextending from the drill housing is inserted into a hollow sleeveextending from the sleeve housing; removably engaging a connectingportion of the drilling member to a dental drilling apparatus; operatingthe dental drilling apparatus to cause the hollow drill to drill a holein a bone and the hollow sleeve to ream the drilled hole, therebyinserting the hollow drill and the hollow sleeve into the bone, saidhollow drill having a length such that a portion thereof extends beyondthe hollow sleeve and is inserted deeper into the drilled hole than thehollow sleeve; disengaging the drill housing and the sleeve housing suchthat the hollow drill is removed from the hollow sleeve and the hollowsleeve is left inserted in the bone; inserting a syringe needle into thehollow sleeve left inserted in the bone; and introducing a fluid fromthe syringe needle directly into the bone via an exposed bottom portionof the drilled hole as well as via exposed side-wall portions at adistal end of the drilled hole.
 3. The intraosseous delivery methodaccording to claim 2, wherein the hollow drill is inserted into thehollow sleeve so as to extend about 3 mm beyond the hollow sleeve. 4.The intraosseous delivery method according to claim 3, wherein thehollow sleeve remains inserted in the bone throughout a dentalprocedure, and wherein fluid is repeatedly injected directly into thebone, if and when necessary, during the dental procedure.
 5. Theintraosseous delivery method according to claim 2, wherein the drill isoperated to drill the hole such that the distal end of the drilled holehas a diameter which is smaller than an outer diameter of the hollowsleeve.
 6. The intraosseous delivery method according to claim 2,further comprising a step of removing the needle of the syringe from thehollow sleeve in a manner such that the hollow sleeve remains insertedin the bone.
 7. The intraosseous delivery apparatus according to claim2, wherein the dental drilling apparatus is operated at a rotation speedof about 10,000 to 25,000 rpm.